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Before you even start Googling “how to find a therapist” or "best therapists in Boston," it’s important to get clear on your needs. Ask yourself the following questions:

1. What are you struggling with? Are you dealing with anxiety, depression, or relationship struggles?
2. What kind of feedback do you want in the room? Are you looking for someone active who will give homework, or someone who is more insight oriented and allows you to explore and drive the process?
3. Are you looking to learn new skills, explore your history and its impact, become more effective in relationships, better understand your feelings, and/or gain relief from specific symptoms?

The better you understand your own goals, the easier it’ll be to find a therapist who can support you in achieving them.

This self-awareness isn’t just helpful – it’s crucial. According to a study published in Psychotherapy (2014), clients who have a clear understanding of their needs and goals are more likely to achieve positive outcomes from therapy. It’s about aligning your needs with the therapist's expertise.

In the world of psychotherapy there is a spectrum of theories that psychologists pull from. They range from behavioral therapy, which is highly active and skills based to psychodynamic therapy, which is more insight oriented and focuses on understanding the past to improve the present.

Different concerns and personality styles have different needs for the type of therapist. For example, if you’re struggling with an anxiety disorder, like Generalized Anxiety Disorder (GAD) or Obsessive Compulsive Disorder (OCD) evidence based behavioral therapy treatments, like Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT) or Acceptance and Commitment Therapy (ACT) have been shown to be the most effective for symptom relief and management.

On the other hand, if you’re struggling in relationships or understanding behavioral patterns, psychodynamic therapy may be a better fit. Whatever your situation, identifying what you need is your first step toward finding the right therapist.

One of the best ways to find a therapist is by asking people you trust for recommendations. Many have had positive experiences with therapists, and sharing recommendations can help you get started.

If you feel uncomfortable asking your friends or family directly, you can always start by browsing online platforms. Reading a therapist's profile and website can give you a good "gut sense."

If you’re in Boston, Aviva Psychology Services offers a free 20 minute consultation to assess fit and has a large team of psychologists with many specialties, including anxiety, mood disorders, PTSD, grief, relationship challenges, and insomnia. Every potential client has a call with our intake team to get a better sense of your needs and what you are looking for. We then match you with a best fit therapist on our team. Once matched, the assessment doesn't end there. We actively encourage your therapist and you to assess needs, discuss them directly, and assess fit in the first 2-4 sessions. Truly assessing fit takes some time, but at Aviva, we aim to provide as much information as we can along the way so that you are empowered to find the best fit for your needs.

As mentioned earlier, there is a spectrum of approaches and therapeutic styles. As you assess your needs, think about the areas of expertise and treatment approaches that may match what you are looking for. At Aviva Psychology Services our therapists can work with a variety of clients, but each have an area of expertise. On our team we have psychologists with expertise in anxiety, depression, grief, infertility and perinatal support, relationship issues trauma & PTSD. If you are clear on an area of expertise you are looking for, whether it's at Aviva or somewhere else, letting your provider know the expertise you are seeking will help them realistically assess if the fit is right for you.

Most therapists have conditions and areas of expertise related to the problems that they work best with. They also have training in specific therapeutic or treatment approaches that inform how they work with a given problem. Some treatment approaches are tied to specific problems, like Cognitive Behavioral Therapy for Insomnia (CBT-I) and others are more general and have empirical support for helping with a variety of presenting concerns. At Aviva, the main models of care across our team include Acceptance and Commitment Therapy (ACT), Cognitive Behavioral Therapy (CBT), Internal Family Systems (IFS), Psychodynamic Therapy, and Relational Cultural Theory.

You can read more detail in the links above, but to here is a brief overview of each:

Acceptance and Commitment Therapy (ACT) is a mindfulness-based approach that encourages acceptance of uncomfortable thoughts and feelings while focusing on behaviors that move you towards clarifying and taking action on personal values.

Cognitive Behavioral Therapy (CBT) is a practical, solution-focused approach that helps individuals identify and change negative thought patterns and behaviors. The link between thoughts, feelings, and behaviors is examined and behavioral strategies are used to work on disrupting the automatic thought patterns that cause distress or unwanted behaviors.

Internal Family Systems (IFS) is an evidence-based, strength-focused approach that helps clients identify parts of themselves that get in the way of their natural sense of confidence, clarity, and calm.

Psychodynamic Therapy is a deeper, more introspective approach that explores past experiences to understand current behaviors and address relational stuck points.

Relational-cultural theory (RCT) is a strengths-based model of psychotherapy that proposes all humans are healthiest in connection. RCT helps clients understand their suffering, which often stems from disconnection and isolation. RCT aims to uncover this and help clients move towards “mutually growth-fostering relationships," which are built on mutual empathy, acceptance and authenticity, and that empower both people in the relationship. 

These are just a few examples of therapeutic approaches. It’s important to find a therapist whose style and approach resonate with you. A study from the American Psychological Association (2017) found that therapy works best when the client resonates and feels comfortable with the therapist's expertise and theoretical approach.

When you’re asking yourself how to find a therapist in Boston, it’s also worth considering logistics. Where is the therapist’s office located? Is it convenient for you? What are their billing and practice policies?

If you live in the suburbs of Boston, for example, getting into the city for a therapy session can become a hassle or barrier to consistent care. Telehealth may be a more appealing option and, if so, this would become an important part of your search criteria.

Another practical consideration is the therapist’s hours. Do they offer sessions at times that work for you? What is their reschedule and/or cancellation policy? Finding a fitting therapist means finding one that fits with your schedule and lifestyle.

If you’re in the Boston area, you may find it helpful to look for practices that offer both in-person and online therapy sessions. Having the flexibility to choose between virtual and face-to-face meetings can make it easier to prioritize your mental health, even during busy times, attend consistently, and avoid frequent cancellations. Consistency in therapy is a primary predictor of positive outcomes.

At Aviva, we aim to provide potential clients with as much information about our availability, logistics, fees, cancelation policies, and clinician hours. This is a vital part of our informed consent process in the 20-minute phone consultation with our intake team.

One of the trickiest aspects of finding a therapist can be navigating insurance coverage. In Boston, like many large cities, a majority of providers are private pay only. Mid-size and larger practices, like Aviva often have the ability to work with insurance companies because of their size and ability to pool resources.

In Massachusetts and in most of the US, health insurance plans are required to cover mental health services at the same rate as medical services. However, this varies widely by plan. Knowing your plan specifics is important for you to be able to estimate your costs for therapy. The easiest way to check if a therapist accepts your insurance is by calling your insurance company or checking their website.

At Aviva, we are in-network with Blue Cross Blue Shield and Aetna. We also file claims for clients with Harvard Pilgrim and Cigna who have plans that cover out of network services. Before your first session, every client is given an estimate of costs based on their particular plan. While insurance companies ultimately dictate coverage and rates for providers who bill insurance, we aim to give as much information as we can so clients can make informed choices.

One of the best ways to find a therapist is to trust your instincts. Your first few sessions, called intake sessions, are focused on gathering a lot of information. For some, these sessions can  feel relieving; when you are finally able to get it all out. For others, it can be an intense process to go through your whole history. Everyone responds a little differently to starting therapy, but it’s completely okay if you don’t feel an instant connection.

After your first session, ask yourself: Do I feel understood? Did the therapist seem empathetic and attentive?  Did they offer helpful feedback? If you're unsure about fit, which is common after the first session, giving feedback can be an important part of the relationship developing process.

Feedback on the therapeutic relationship is welcome and important. Especially at Aviva, we welcome feedback as an opportunity for clarifying needs and furthering connection. Even if that feedback and exploration leads to learning that you and your therapist are not a perfect fit, giving this feedback can often help guide you towards what might be more fitting. As therapists we know that we have particular styles, theoretical frameworks, and areas of expertise. Being a great fit for one person does not mean we are a great fit for all. Our goal at Aviva is to make sure your needs are met and with a diverse team, we can often help find a fit within or outside Aviva with this feedback. 

Although finding the right therapist in Boston is certainly a process, it doesn’t have to be a stressful or overwhelming one. By understanding and asserting your needs, having realistic expectations, asking for recommendations, and researching therapists’ qualifications and specialties, you’ll be well on your way to finding the support you need.

At Aviva, we aim to have a relational and informative intake process for all clients at our practice. Using this framework, we aim to assess needs (to the best of your knowledge at the time - and not knowing is totally ok! That might be your starting point) and match you with a therapist who can best meet those needs. It's an evolving process and we hope to support you on your therapeutic journey from beginning to end.

1. How do I know if a therapist is the right fit for me?

The therapeutic relationship is built on trust and connection, which takes time and effort to build. Remember that a successful therapy relationship is co-created. With this in mind, remember to ask yourself, "what am I doing to get my needs met in this process?" and "have I made my needs and concerns known directly?" If you haven't done those things, that's likely part of your essential work before any therapy space can be effective. If you are doing those things, but still not making progress towards your goals, you can trust that this is not the right fit and keep your search going. A combination of "your gut" and "your work" will guide you well. Pay attention to both as you explore fit.

2. How can I find a therapist who accepts my insurance?

Finding a therapist who accepts your insurance can be challenging. Especially in a city like Boston where hospital systems make directories look fuller than they are. The best start is to contact your insurance provider directly and get a list of in-network providers. Be mindful that around city centers (like Downtown Boston), there are many providers that are a part of large hospital systems (like Mass General) and may or may not be directly accessible like a private practitioner.

The other option is to contact the therapist/practice directly. Remember to inquire about both in and out of network benefit mental health coverage with your specific insurance plan for any therapist you are interested in seeing. This will help give you a realistic sense of your coverage and responsibility. If the arrangement is not sustainable, keep your search going and narrow it down to in-network providers only. 

3. Can therapy be done online or does it have to be in person? 

Yes, many therapists offer both in-person and online therapy. Online therapy has become increasingly popular, especially after the pandemic, and it provides the flexibility to attend sessions from the comfort of your home. This option is particularly helpful for those with busy schedules or for those who live farther from therapy offices. Be sure to ask your therapist if online sessions are available to fit your needs and remember that you must be in the state that the provider is licensed in during the time of the session.